Background- A small proportion of patients undergoing coronary artery bypass surgery had endarterectomy of one or more vessels. Patients characteristics, early postoperative outcome, and mid-term survival in endarterectomy bypass surgery patients were investigated.
Methods- A total of 2339 consecutive patients undergoing isolated CABG from April 2002 to May 2003 were studied, 4% of whom had endarterectomy. Demographic and periprocedural data were registered retrospectively in a computerized institutional database. Results- The endarterectomy CABG group was younger and included a higher proportion of females, and patients with diabetes, hypertension, lower ejection fraction, triple vessel disease and unstable angina. They required longer cross-clamp and cardiopulmonary bypass times.
Intensive care unit and hospital stays were prolonged and blood product transfusions, need for inotropic support and/or intra-aortic balloon-pump was higher in endarterectomy patients. Perioperative mortality (30 days) was 6.25% vs. 3.5%. Cumulative one-year survival was 79% versus 86.2% (p<0.001).
Conclusions- Short-term mortality was almost two-fold in endarterectomy patients after CABG and they had increased postoperative mortality in comparison with regular CABG patients, particularly with regard to bleeding and infections. One-year survival was impaired in endarterectomy patients, mainly because of a less-favorable outcome and early closure of grafts (Iranian Heart Journal 2002, 2003; 3(4&4(t): 56-60).